Form CDPH6247 Authorization for Use and Disclosure of Personal Information - California

What Is Form CDPH6247?

This is a legal form that was released by the California Department of Public Health - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is CDPH6247?
A: CDPH6247 is the Authorization for Use and Disclosure of Personal Information form for California.

Q: What is the purpose of CDPH6247?
A: The purpose of CDPH6247 is to provide consent for the use and disclosure of personal information in California.

Q: Who needs to use CDPH6247?
A: Anyone who wants to authorize the use and disclosure of their personal information in California needs to use CDPH6247.

Q: What information is required in CDPH6247?
A: CDPH6247 requires you to provide your personal information, the purpose for which the information will be used, and any limitations on its use or disclosure.

Q: Is there a fee for using CDPH6247?
A: There is no fee for using CDPH6247. It is a free form provided by the California Department of Public Health.

Q: How long is CDPH6247 valid for?
A: The validity of CDPH6247 depends on the specific authorization granted, but it is generally valid until revoked in writing.

Q: Can CDPH6247 be used for minors?
A: Yes, CDPH6247 can be used for minors, but a parent or legal guardian must sign the form on behalf of the minor.

Q: What happens if I don't submit CDPH6247?
A: If you don't submit CDPH6247, your personal information may not be used or disclosed as requested, unless there is another legal basis for doing so.

Q: Can I revoke my authorization on CDPH6247?
A: Yes, you can revoke your authorization on CDPH6247 at any time by submitting a written revocation to the entity that received the authorization.